Laserfiche WebLink
P�r�MIT APPLICATIG�J <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.M PERMiT x <br /> /p � �12 /� oy3�17-�9a- �,s,�u b oac, -03 <br /> LEGA LOT NO. BLOCK RACT vOI?D�- � <br /> oESo. Zg,�2 L ��1' e� r r�s ►+�. o <br /> OWNER ADORESS PHONE <br /> �u� ��q�r'�Gic �sE /0/� ��E �-GtG7r'� �l b�l �t3' .ZS�-S73 <br /> TENANT NAME I CO TACT NAME PHONE <br /> CON�ACT� �fi,_/� ., ��.��� %ZQE���G A� ZIP CONTR.LICENSE M <br /> � 9�s.�.r� 7 LJ 5����11 P+� <br /> PHONE �/`//Mg� �lJ�[. 7/�31 <br /> �(00 75��ti�30 <br /> PROPOSED USE OF BUILDING � Building D Mechanicai Addi�ion HEAT SOURCE <br /> ^ I PERMIT R Combina�ion U Plumbing WORK � Altr.ralion � Electric <br /> c/� F�� � TYPE Demolition U Sign 7YPE New Gas <br /> J 1 I ` B Sprinkler f� Fepair/Mainl. Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE�S 3705 <br /> WORK DESCRIPTION �L 2�� �, I <br /> I(. <br /> \ <br /> PLUMBING � MECHANlCAL <br /> i <br /> N0. TYPE OF FIXTURE OR ITEM �. � NO` �TYPE OF J(TURE OR ITEM <br /> _ WATER CLOSET r � A/C-AlHANDLING UNITS <br /> BATHTUB �FOF�CED AIR SYSTEMS <br /> LAVATORY (WASH BASIN) ` � H�AT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES ORYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN _ GAS FIREPLACE <br /> FLOOR ORAIN _ GAS RANGE <br /> BACKFIOW PREVENTER GAS PIPING <br /> SINK (SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER _ OTHER <br /> I HEfiEBY CERITIFY'HAT I HAVE READ AND EXAMINED THIS APPLICATION ANO KNOW THE SAME TO BE TRUE AN�COFiRECT. ALL <br /> PROVISIONS OF f.AWS AN�ORIDINACES GOVERNING THIS TYPE O'r WORK WIIL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OA <br /> NOT. THE GAANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOL4TE OR CANCEL THE PROVISION OF ANY OTHER <br /> S7ATE OR LOCAL LA`+V REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHURIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATiON IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 FCW�96.200 WAC. <br /> , � � <br /> t� - 'i <br /> Sig ner ntra�r/AuthonzedAgenl Date <br />